摘要
目的通过调查宁夏石嘴山地区590例志愿者幽门螺杆菌(HP)感染及耐药情况,分析该地区HP感染及耐药的特点。方法选取宁夏石嘴山地区的590例志愿者,采用自拟HP调查问卷的形式调查志愿者的临床资料,采用尿素14C呼气试验(14C-UBT)检测HP感染情况,胃镜下留取HP感染者胃黏膜标本行HP体外培养;取培养菌落采用革兰染色、触酶试验、尿素酶试验法确认为HP菌株后分离培养出的HP菌株,采用Kirby Bauer纸片扩散法检测HP菌株对阿莫西林、呋喃唑酮、四环素、甲硝唑、克拉霉素、左氧氟沙星的耐药性。对比分析不同基线资料志愿者HP感染及耐药情况。结果590例志愿者经14C-UBT检测共发现300例感染HP,HP感染率为50.84%。300例感染HP志愿者经体外培养共分离出HP阳性菌株160株,HP菌株检出率为53.33%。男性、生活地区为农村、家庭月收入<3000元、受教育程度在初中及以下、吸烟、经常共用餐具及水杯的志愿者HP感染率较高(P均<0.05)。160例HP阳性菌株中,对甲硝唑、左氧氟沙星、克拉霉素、阿莫西林、呋喃唑酮、四环素耐药的菌株数分别为147、70、69、2、1、1株,耐药率分别为91.87%、43.75%、43.12%、1.25%、0.62%、0.62%。160例HP阳性菌株中共有单一耐药菌株52株(32.50%),其中甲硝唑单一耐药49株(30.63%),阿莫西林、呋喃唑酮、四环素单一耐药各1株(0.62%);共有双重耐药菌株60株(37.50%),其中甲硝唑+克拉霉素、甲硝唑+左氧氟沙星的双重耐药菌株各30株(18.75%);共有三重耐药菌株37株(23.13%),均为甲硝唑+克拉霉素+左氧氟沙星耐药株;有四重耐药菌株1株(0.62%),为阿莫西林+甲硝唑+克拉霉素+左氧氟沙星耐药株。160例HP菌株检出者中,生活地区为农村者左氧氟沙星耐药率高于生活地区为县城者(P<0.05);其他临床资料甲硝唑、左氧氟沙星、克拉霉素耐药率比较差异均无统计学意义。结论宁夏石嘴山地区HP感染率为50.84%,男性、生活地区为农村、家庭月收入<3000元、受教育程度在初中及以下、吸烟、经常共用餐具及水杯者HP感染率较高;石嘴山地区HP对甲硝唑、克拉霉素、左氧氟沙星的耐药性较高,生活地区为农村者左氧氟沙星耐药率高于生活地区为县城者。
Objective To investigate the Helicobacter pylori(HP)infection and drug resistance in 590 volunteers in Shizuishan area of Ningxia to analyze the characteristics of HP infection and drug resistance in this area.Methods The clinical data of 590 volunteers in Shizuishan,Ningxia in the form of a self-designed questionnaire on HP were selected.14C urea breath test(14C-UBT)was used to detect HP infection.The gastric mucosa samples of HP infected patients were collected under the gastroscope for HP culture in vitro.The culture colonies were confirmed as HP strains by Gram staining,thiase test and urease test,and the HP strains were isolated and cultured.The resistance of HP strains to amoxicillin,furazolidone,tetracycline,metronidazole,clarithromycin and levofloxacin was detected by Kirby Bauer disk diffusion method.HP infection and drug resistance of volunteers with different baseline data were compared and analyzed.Results A total of 300 cases of HP infection were detected by 14C-UBT test in 590 volunteers,and the HP infection rate was 50.84%;160 HP positive strains were isolated from 300 HP infected volunteers in vitro,and the detection rate of HP strain was 53.33%.Volunteers who were male,lived in rural areas,had a monthly household income of less than 3000 yuan,had an education level of junior high school or below,smoked,and frequently shared tableware and water cups had a higher incidence of HP infection(all P<0.05).Among 160 HP positive strains,147,70,69,2,1 and 1 strains were resistant to metronidazole,lefofloxacin,clarithromycin,amoxicillin,furazolidone and tetracycline,and the resistance rates were 91.87%,43.75%,43.12%,1.25%,0.62%and 0.62%,respectively.Among the 160 HP positive strains,52(32.50%)were single-drug resistant,among which 49(30.63%)were single-drug resistant to metronidazole,and 1(0.62%)each was single-drug resistant to amoxicillin,furazolidone and tetracycline.There were 60 double-resistant strains(37.50%),among which 30 strains(18.75%)were resistant to metronidazole+clarithromycin and metronidazole+levofloxacin;37(23.13%)were triple-drug resistant strains which were resistant to metronidazole+clarithromycin+levofloxacin.There was a quadruplex drug-resistant strain(0.62%),which was amoxicillin+metronidazole+clarithromycin+levofloxacin-resistant strain.Among 160 HP strains detected,the levofloxacin resistance rate of the patients living in rural areas was higher than that of the patients living in county areas(P<0.05).There were no significant differences in drug resistance rates of metronidazole,levofloxacin or clarithromycin in other clinical data.Conclusions HP infection rate was 50.84%in Shizuishan,Ningxia.Volunteers who were male,lived in rural areas,had a monthly household income of less than 3000 yuan,had an education level of junior high school or below,smoked,and frequently shared tableware and water cups had a higher incidence of HP infection.The resistance of HP to metronidazole,clarithromycin and levofloxacin was higher in Shizuishan area,and the resistance rate of levofloxacin in rural area was higher than that in county area.
作者
苏小明
祁海龙
王小云
王平
李成
唐媛媛
呼圣娟
SU Xiaoming;QI Hailong;WANG Xiaoyun;WANG Ping;LI Cheng;TANG Yuanyuan;HU Shengjuan(The Third Clinical Medical College,Ningxia Medical University,Yinchuan 750002,China)
出处
《山东医药》
CAS
2023年第17期15-20,共6页
Shandong Medical Journal
基金
宁夏回族自治区重点研发计划项目(2019BEG03005,2019BEG02025)。
关键词
幽门螺杆菌
耐药性
抗生素
宁夏
石嘴山
helicobacter pylori
drug resistance
antibiotics
Ningxia
Shizuishan
